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County to improve access to behavioral health services

The San Diego County Board of Supervisors voted June 25, to increase access to behavioral health services in North County with plans for additional investments across the region.

The vote allowed the county Health and Human Services Agency to increase an existing contract with Palomar Health to enhance hospital-based, crisis stabilization services. It also directed county staff to explore the feasibility of investing in additional inpatient psychiatric care facilities in North County hospital districts.

“Today, the board is taking critical steps to improve the region’s behavioral health system,” board Chairwoman Dianne Jacob said. “It’s part of a bigger effort to turn what is become a fractured approach to mental health and addiction into a coordinated system of care.”

The augmented contract will cost $4.4 million during the 2019-2020 fiscal year and $6.4 million the year after that.

Crisis stabilization services are designed to help people experiencing a mental health crisis who require a timelier response than a regularly scheduled visit to an outpatient clinic. These services provide ongoing assessment and stabilization, which may include treatment with medication and linkages to other services.

Palomar Health’s behavioral health services have been under stress since Tri-City Medical Center’s behavioral health unit closed last year.

Under the new contract, Palomar Health will be able to serve more patients by increasing patient recliners from six to 12. Four of those recliners would be in a discreet area of the Palomar Health Emergency Department and will be used to monitor patients experiencing a mental health crisis and need extended observation.

“We know that regional crisis stabilization services are a critical need, especially in North County,” Supervisor Kristin Gaspar said, who requested a conference late last year on the status of behavioral health services in the region. “It’s imperative that we continue to work collaboratively to address the entire continuum of care and make the necessary investments into models of intervention that are proven to be successful and more therapeutic for the person.”

The move is expected to result in fewer hospitalizations, fewer readmissions, more access and sustained engagement to treatment for people experiencing a psychiatric crisis.

The new psychiatric beds were recommended during the second quarterly update to county supervisors from county Behavioral Health Services on how to improve the continuum of care for people with mental health issues or substance abuse problems.

BOLD - 24/7 Crisis Centers Coming

The board also adopted the recommendation to strengthen the county’s ability to respond to behavioral crisis situations that intersect with the criminal justice system, starting in North County.

The objectives, developed with coordination from the sheriff’s department and the district attorney’s office, would include timely follow-up care and case management system for people involved in a Psychiatric Emergency Response Team or law enforcement crisis call; establishment of regional Crisis Stabilization Centers that provide 24/7 walk-in mental health services, including law enforcement drop-offs and enhanced school-based crisis response for threats or crisis situations involving school youth.

The goal is to enhance follow-up care and create a direct path for law enforcement to connect with the county’s Access and Crisis Line, which has highly trained counselors who speak multiple languages and are available 24-hours a day, seven days a week. Law enforcement will also have direct access to mobile crisis response teams who will serve clients who do not need to be transported but need additional crisis intervention and attention in the field.

The new services will cost about $1 million during the 2019-2020 fiscal year and $12 million the following year. The mobile crisis response teams will also be piloted in North County and will cost between $500,000 and $1 million annually.

Over the past year, District Attorney Summer Stephan has led several county-wide efforts, bringing approximately 200 stakeholders and experts together to map the intersection of mental health, homelessness and criminal justice, to better identify the problems and recommend concrete solutions.

Similarly, Sheriff William Gore has expanded the availability of mental health services to inmates in county jails, as well as increased the quality of those services.


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